Torrential rain this morning. Walked in with Helen, raincoats on, pretty grim. Wet feet when I arrived at the hospital, need to get some new shoes as my right toe has a hole in it! Board round, pretty quiet again. Attached myself to surgical ward round, very brief whizz through the surgical inpatients. Black Wednesday today, the first unsupervised day for the F1s! Those of us on the ward round had a teaching session by one of the really nice surgeons on how to administer a chemotherapeutic agent through a catheter to treat bladder cancers, the F1 was taking notes as they'll probably have to do that on their own next time. Must be pretty daunting, being dropped into a job and having to quickly learn the ropes.
After that I went off to theatre to check if the one patient on the list was going ahead; it was so I changed into some scrubs and went in. Scrubbed in for the first time in a while, always good to practice it and go through the motions again. I'm sure after a while it becomes second nature - doing the social wash to the elbows, getting the scrubbing brushes for the nails, few more washes, then pat drying each arm with a towel, putting gown on, asking a nurse politely to do up the back while you get the gloves on. This is always a fun part, takes practice! You have to open up the sterile glove pack using your hands whilst they're still inside the arms of you gown so you don't contaminate. Then pull on the right glove first, battling to get the thumb in, as the cuff of you gown is still at knuckle level at this point. Then left glove goes on, easier as can use your gloved right hand. Then you pull the gloves on tight by pulling the sleeves up your arm, dragging the cuff from knuckle level to mid hand level. After that the final stage is handing a piece of card to one of the people in theatre, doing a 360 twizzle and tying up the gown. Done! Hopefully you remembered to put a face mask on before you started, as once you're gowned up there's no touching anything that's not sterile! That includes itchy faces...
Patient got wheeled in from the anaesthetics room, theatre staff swung into action while the surgeon was scrubbing, preparing the sterile fields, cleaning, adjusting laparoscopy screens. The operation was done using cameras and instruments put into the abdomen via little incisions dotted around. I had the job of holding the camera and trying to follow the surgeons tools, as they were working inside the abdomen, which is inflated with gas so you can see stuff inside. Awesome! Love surgery. Before long the surgeon was finished and time to close up all the holes. The moment I'd been patiently waiting for came when the scrub nurse prepped one of the suturing needles and then asked "Are you suturing or Martin?". Surgeon looked at me, asked if I'd done any, said yes (which I have) and then basically left me to get on with closing up the holes on the patients left hand side! Small things, but such good fun and really great to be able to get involved. The surgeon closed the holes on the other side and just left me to get on with my side. Two small 10mm incisions, and one larger one from the main camera port, about 30mm which I closed with 3 stitches. Tied the sutures down by hand tying, as our gynae consultant last year was very keen on this and made sure we all knew how to do it! Need to have a practice with instrument tying to make that fresh again. So only 5 stitches in total but was brilliant, feels great to be left to your own devices, and be trusted with closing up someone's abdomen. Was nice as well afterwards, as when the scrub nurse was cleaning the sites she said it was very neat - probably just saying it but I'll take it anyway!
I really enjoy surgery, and although I've not got that much experience in theatre the stuff I have done/seen I've really enjoyed. Working with my hands and making definitive interventions is really satisfying - on the flip side though the training is meant to be killer. And you meet all the type A personalities, the surgeons who you probably wouldn't want looking after your mum. Lots to think about.
Back to ward, cannula commotion causing consternation - I'll say no more. Lunch break followed. Back to the doctors office and I tidied up the white boards, cleaning the white spaces and redrawing the separator lines - was accused of 'having problems' when doing this, as I was pretty meticulous, there wasn't much else going on... Shortly after this I left and came back to house to chill. 2 hours of violin practice, bit of TV, pasta dinner, long Skype to Alice. Super chilled evening. Going out cragging tomorrow, weather forecast looking good. Will get some photos!
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